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Spotlight On… Vasculitis

by Deen Kurrimbux

Vasculitis is the inflammation of the blood vessels. The result of inflammation is due to the immune system’s reaction to infection or damage. The blood vessels leak plasma (a blood constituent) causing the surrounding cells to swell up isolating any potential micro-organism. Vasculitis is an auto-immune disease meaning that the body’s immune system will attack the blood vessels by mistake. There are factors, however, that will trigger this response: it could be medicinal, an infection of pre-existing medical conditional. More than half of cases are idiopathic (unknown cause).

In vasculitis the blood vessel walls swell causing the vessel passage to narrow which leads to a much reduced blood flow or even a blockage. Vasculitis affects any blood vessels regardless of size or location, however the larger the blood vessel the more damage there is when that vessel is compromised.

Due to its varied and complex nature, there are many types of vasculitis:

  • Giant cell arteritis – is an age-related condition in which the arteries in the head and neck are inflamed. Symptoms include vision loss, jaw muscle ache when eating and soreness around the temples. It mainly affects adults over 50 with an unknown cause.
  • Polymyalgia rheumatic – an age-related condition causing stiffness, pain and inflammation in the areas around the shoulders, hips and neck. It may also cause fever, depression, weight loss and tiredness. It is up to three times more common n females. The cause is idiopathic.
  • Polyarteritis nodosa – a rare form of vasculitis where the small and medium vessels become inflamed. In some cases only a part of the vessel wall is affected forming a bulge (aneurysm) which may weaken and burst causing internal bleeding which in turn can be fatal if undetected or left too late. Typical symptoms are fever, weight loss and nerve damage.
  • Microscopic polyangiitis – a rare but potentially serious long-term vasculitis condition. The inflammation of adjoining blood vessels causes the lungs nervous system and kidneys to become inflamed also. This leads to reduced kidney function, high blood pressure and breathlessness among other symptoms.
  • Kawasaki disease – another rare condition that affects children under the age of five. Symptoms of Kawasaki include a long lasting fever (five or more days), redness in the fingers and toes, mouth and tongue, swollen glands in the neck. Because it can affect the vessels supplying blood to the heart (coronary arteries) the affected individual must be closely monitored in a hospital for further heart complications.
  • Eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome) - a type of vasculitis that typically causes allergic sinusitis (inflammation of the sinuses) and asthma to develop in adults. Symptoms include, fever muscle pain, weight loss and loss of appetite.

Treatment varies considerably according to the underlying cause, the severity of symptoms and their duration. In the cases of surgery the procedure would be to provide alternative means around the blocked or damaged vessels.

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